Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty
Background: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Joint Implant Surgery & Research Foundation
2020-12-01
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| Series: | Reconstructive Review |
| Subjects: | |
| Online Access: | https://reconstructivereview.org/ojs/index.php/rr/article/view/238 |
| _version_ | 1818556015812018176 |
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| author | Michael Le Dante Maestri Bob Jang Jason Chinnappa Sol Qurashi |
| author_facet | Michael Le Dante Maestri Bob Jang Jason Chinnappa Sol Qurashi |
| author_sort | Michael Le |
| collection | DOAJ |
| description | Background: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently unknown. This study aims to describe early rises in serum Co and Cr at 6 months post-operatively.
Methods: A prospective cohort study of 100 consecutive patients with an uncemented titanium stem from a single THA manufacturer was performed. Patients had either a metal (n=50) or ceramic (n=50) head articulating with a highly cross-linked polyethylene. Serum Co and Cr levels were measured 6 months post-operatively. Analysis compared mean values between groups and to determined baseline levels. Subgroup analysis investigated the effect of femoral head size and offset on metal ion levels.
Results: A mean difference of 2.259 nmol/L (95% CI 0.449-4.069; p=0.015) was found when comparing 6-month serum Co in the metal head group compared to baseline. No significant differences were found in serum Cr (p=0.943). Mean serum Co levels were higher in the MoP group compared to the CoP (Ceramic-on-Polyethylene) comparator group (p=0.012). There were no differences in serum Cr (p=0.976). Variations in femoral head size and offset did not impact metal ion levels.
Conclusion: At six months, a higher magnitude of serum Co exists in metal heads when compared to baseline (p=0.015) and to ceramic heads (p=0.012). Further study is required to determine whether serum concentrations of metal ions will continue to increase over time. |
| first_indexed | 2024-12-13T23:42:00Z |
| format | Article |
| id | doaj.art-8288f1aee11447e3bd6149960b8e4b50 |
| institution | Directory Open Access Journal |
| issn | 2331-2262 2331-2270 |
| language | English |
| last_indexed | 2024-12-13T23:42:00Z |
| publishDate | 2020-12-01 |
| publisher | Joint Implant Surgery & Research Foundation |
| record_format | Article |
| series | Reconstructive Review |
| spelling | doaj.art-8288f1aee11447e3bd6149960b8e4b502022-12-21T23:27:09ZengJoint Implant Surgery & Research FoundationReconstructive Review2331-22622331-22702020-12-0110110.15438/rr.10.1.238Early Post-operative Rises in Serum Metal Ion Levels in Total Hip ArthroplastyMichael Le0Dante MaestriBob JangJason ChinnappaSol QurashiSt George HospitalBackground: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently unknown. This study aims to describe early rises in serum Co and Cr at 6 months post-operatively. Methods: A prospective cohort study of 100 consecutive patients with an uncemented titanium stem from a single THA manufacturer was performed. Patients had either a metal (n=50) or ceramic (n=50) head articulating with a highly cross-linked polyethylene. Serum Co and Cr levels were measured 6 months post-operatively. Analysis compared mean values between groups and to determined baseline levels. Subgroup analysis investigated the effect of femoral head size and offset on metal ion levels. Results: A mean difference of 2.259 nmol/L (95% CI 0.449-4.069; p=0.015) was found when comparing 6-month serum Co in the metal head group compared to baseline. No significant differences were found in serum Cr (p=0.943). Mean serum Co levels were higher in the MoP group compared to the CoP (Ceramic-on-Polyethylene) comparator group (p=0.012). There were no differences in serum Cr (p=0.976). Variations in femoral head size and offset did not impact metal ion levels. Conclusion: At six months, a higher magnitude of serum Co exists in metal heads when compared to baseline (p=0.015) and to ceramic heads (p=0.012). Further study is required to determine whether serum concentrations of metal ions will continue to increase over time.https://reconstructivereview.org/ojs/index.php/rr/article/view/238TrunnionosisArthroplastyCobaltChromiumfemoral offsetFemoral head size |
| spellingShingle | Michael Le Dante Maestri Bob Jang Jason Chinnappa Sol Qurashi Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty Reconstructive Review Trunnionosis Arthroplasty Cobalt Chromium femoral offset Femoral head size |
| title | Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty |
| title_full | Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty |
| title_fullStr | Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty |
| title_full_unstemmed | Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty |
| title_short | Early Post-operative Rises in Serum Metal Ion Levels in Total Hip Arthroplasty |
| title_sort | early post operative rises in serum metal ion levels in total hip arthroplasty |
| topic | Trunnionosis Arthroplasty Cobalt Chromium femoral offset Femoral head size |
| url | https://reconstructivereview.org/ojs/index.php/rr/article/view/238 |
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